Gary Taubes’ book Why We Get Fat and What To Do About It is quite an informative read. If this is the first time you are coming across his material, however, prepare yourself to be skeptical about his views on nutrition. He replaces the widely accepted “calories in/calories out” explanation for obesity (stemming from the first law of thermodynamics) with the following train of thought: “obesity is a disorder of excess fat accumulation; overeating and inactivity are compensatory effects, not causes; we don’t get fat because we overeat; we overeat because our fat tissue is accumulating excess fat.” This can be a tough concept to grasp given that for nearly three decades, we have been exposed to quite a different interpretation of why one may struggle with weight gain.
Although I initially questioned how Taubes would disprove the concept of energy in/energy as the means for weight maintenance, he accomplished this with great success. Through extensive scientific evidence, he explains how obesity results from the impact that insulin has on our fat cells. His use of detail, scientific research dating as far back as the 1700’s, and tendency to spiral back to key points elucidates his ongoing theme of both why and how we accumulate fat. According to Taubes (and this remains a tough one for me to crunch on), it’s not because we’re sedentary or gluttonous; it’s because our sensitive endocrine systems have been thrown off balance.
Through a variety of different avenues, Taubes refutes the energy in/energy out theory, nudging his reader towards embracing a very different postulation. Summarized well by George Cahill, a retired Harvard professor of medicine and expert on insulin, “Carbohydrates is driving insulin is driving fat.” Negating the widespread belief that our current obesity epidemic stems from a post-industrial revolution pace of life that facilitates more calories in, fewer calories out, he highlights the following truths: Obesity has increased threefold in the past 50+ years and diabetes is three times more common today than in 1980; throughout various cultures and across hundreds of years, we have seen cases of obese populations who are undernourished while leading physically demanding lives (e.g.: Pima Indians of Arizona); if the calories in/calories out theory were true, then averaging a surplus of 20 extra calories per day would equate to 20 extra pounds over the course of a decade; one’s gender often determines fat deposition; during puberty boys tend to lose fat and gain muscle, whereas girls tend to gain fat; lipodystrophy results in the gradual loss of subcutaneous fat in the forehead and moves down over time with localized obesity ending up below the individual’s waist. None of these truths can be explained by the nutrition theory based on the first law of thermodynamics.
The reader begins to realize that prior to the second world war, ruminations about why we gain weight did not revolve around the notion that if we move more and eat less, we will stay in shape. In fact, many studies showed that if we force caloric restriction, we not only start to expend less energy, but our metabolism slows down. This seems like a sub-optimal state for weight loss and, time and again, we have seen that people following these types of diets do not experience success over the long haul. During this pre-war time period, German and Austrian scientists were at the forefront of research which continued to point to carbohydrates as the culprit of weight gain. After the war, unfortunately, Americans turned a blind eye to much of what these scientists had to say and, instead, adopted what has ended up being a somewhat harmful notion of the causalities of obesity (adiposity is brought on by an imbalance in the energy in/energy out equation).
I believe Taubes deserves a significant amount of credit for starting to flip this erroneous principle on its head. In the “Adiposity 101” part of Why We Get Fat, he gets into the nuts and bolts of how fat tissue is regulated by hormones, enzymes and our nervous system and that when this delicate system is dis-regulated, we start to accumulate fat. He builds a foundation of understanding around this topic, as he educates the reader about the science behind fat storage in the human body. He clarifies: fat is stored as triglycerides; fatty acids are burned for fuel; fat enters and exits fat cells as fatty acids; inside fat cells, fatty acids are continually transformed to triglycerides and then back to fatty acids; fatty acids are small enough to get in an out of fat cells, whereas triglycerides are too large to permeate the membrane of a fat cell; anything that breaks down triglycerides works to use fat; anything that functions to build up triglycerides, works to store fat.
With this foundation, Taubes is able to pose the following questions: “What factor influences the flow of fatty acids?” and “What builds up and/or breaks down triglycerides?” The answer: INSULIN. This hormone is the main regulator of fat metabolism. It is the hormone that works to put fat into fatty tissues. If individuals want to burn excess fat as energy (in other words, get fatty acids out of fat cells), they have to lower their insulin levels. How? Insulin is secreted in response to sugars in the blood stream, which are often the result of carbohydrate/sugar consumption. At the very least, Taubes wants you to walk away with the realization that if you are struggling with weight gain, you need to minimize your carbohydrate/sugar intake. As a result of genetics/bio-individuality, the level of restriction varies from person to person. He does not outline meal plans or a diet regime, however in the Appendix,No Sugar, No Starch Diet: Getting Started, he does offer tips on how to approach this mode of eating.
When you finish this 200+ page read, you may feel slightly overwhelmed (as I did) with the vast amount of information you have just absorbed. If you wish to reinforce the main ideas in this text, consider some of these additional resources:
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